Are you currently... *

Dating

Cohabiting

Engaged

Married

Please can you let us know if any of the following apply (or used to apply) to you or your relationship? *

Therapeutic Coaching is not suitable for all couples and we want to make sure that we are the best people to help you

childhood trauma or abuse

domestic abuse

alcohol or drug addictions

depression

suicidal thoughts / ideations

severe mental health issues or episodes of self harm

complex sexual issues

where one (or both) of you is still involved in an affair

where one (or both) of you has already decided to end the relationship

none of the above apply

Please select all that apply *

There are limited evening sessions available

We are available during the day

We are available in the evening

We are interested in a Day Intensives

Confirmation of Consent *

By completing and submitting this form, and ticking this box, you are consenting for us to retain this information in order to follow up your enquiry. If for any reason, you do not become a client of ours, we will remove all special information from our records as per our Privacy Policy (which can found by following the link at the bottom of our website).

Yes I consent for The Relationships Academy to follow up my enquiry